Technology Enhanced Learning Task Force

Final Report

University of Minnesota

Medical School

January 30, 2005

Stuart M. Speedie, PhD

Chair

Table of Contents

Executive Summary. 3

Introduction. 5

Charge to the Task Force. 5

Membership List 6

Deliberative Process. 6

Summary Review of the Literature. 7

Recommendations. 9

Recommendation: Learning Spaces (Rank 1) 9

Recommendation: Multi-Site Access (Rank 2) 13

Recommendation: Simulations (Rank 2) 16

Recommendation: Blended Courses ( Rank 2) 18

Recommendation: Ad Hoc Communications (Rank 3) 20

Recommendation: Electronic Medical Records ( Rank 3) 22

Recommendation: Computer-based Testing (Rank 3) 24

Recommendation: Performance Tracking ( Rank 3) 26

Recommendation: Parity ( Rank 4) 27

Recommendation: eLearning Preparation ( Rank 4) 30

Recommendation: eLearning Resource (Rank 4) 31

Summary. 32

Appendix A: TEL Task Force White Paper 33

Appendix B: Literature Review.. 42

Appendix C: TEL Best Practices at the University of Minnesota Medical School 43

Appendix D: Technology Enhanced Learning Methods. 52

Executive Summary

In October 2004 Dean Powell directed Senior Associate Dean Kathleen Watson and Stuart Speedie, Director of Education Informatics, to convene a task force to consider the utility and costs of additional investments in technology enhanced learning (TEL) for undergraduate, graduate and continuing medical education. The motivation for this work arose from several sources. The University of Minnesota’s planning priorities for the Biennial Budget placed additional emphasis on technology enhanced learning. There was also a desire to further explore ways by which vertical integration of medical education could be achieved, how these technologies could be employed to address the issues raised by the latest LCME report concerning the relationships between the Twin Cities and Duluth campuses and how TEL might play a role in addressing the larger issues facing medical education in the context of today’s health care system.

Charge to the Task Force

The task force received the following charge from Dean Powell with respect to their considerations of technology enhanced learning: The group was to make recommendations for use of information technology that would:

1. Ensure comparability of learning experiences for students across sites in the Medical School with special emphasis upon the Duluth Campus, but also consideration of other sites, such as RPAP and the Twin Cities community sites for clinical medicine.
2. Identify the equipment and technologic infrastructure required to facilitate vertical integration of teaching and off-schedule, self-directed learning for undergraduate and graduate medical education.
3. Identify the equipment and technologic infrastructure required to facilitate rigorous, reflective outcomes-based evaluation of student performance.
4. Review the medical educational literature and national (e.g. AAMC) task forces on the best practices in effective technology-enhanced learning and evaluation methods.
5. Provide examples of best practices in Technology-Enhanced Learning currently being used in UME, GME and CME at the University of Minnesota.
6. Create matrices of instructional and evaluation methods in Technology-enhanced learning, as a reference for faculty.
7. Make recommendations for personnel needed to create and maintain new technologies.
8. Estimate the costs per student associated with the equipment, technologic infrastructure and personnel.

Below are the recommendations of the task force that address items 1,2, 3 of the report. The report also addresses cost issues within each of the recommendation discussions. A matrix summarizing the TEL findings from the literature is contained in Appendix B. A list of TEL best practices at the Twin Cities and Duluth campuses is provided in Appendix C. Appendix D provides a table listing the TEL strategies used for instruction and assessment and briefly discusses the applicability of each.

Task Force Recommendations

The following recommendations are put forth by the TEL task force in response to the charge to the group. Each row provides label and a one sentence summary of the entire recommendation. And the ranked order of importance in meeting that charge. Multiple recommendations may be listed at the same rank indicating that the task force considered them to be of equal importance.

Rank	Label	Recommendation Summary
1	Learning Spaces	Create/adopt a common, standard, secure, permanently available student-centered on-line learning space
2	Multi-site Access	Provide multi-site, multi-media access to clinical education activities such as seminars, Grand Rounds, Morning Reports, and clerkship didactic presentations that are accessible from anywhere and at any time with a network connection.
2	Simulations	Increase the use of technology-based simulations and simulators for teaching and evaluating procedural skills.
2	Blended Courses	Work to evolve both basic science and clinical courses with significant lecture content to a more blended approach consisting of a mixture of face-to-face group meetings combined with self-study modules, case-based learning, narrated slide presentations and other on-line activities that the student can complete on their own schedule.
3	Ad Hoc Communications	Develop/adopt means for faculty and students to communicate easily and frequently on an ad hoc basis with each other regardless of site to facilitate advising and student group communications.
3	Electronic Health Record	Introduce the electronic medical record as a teaching tool from the very beginning of the curriculum and work to assure that students have appropriate access to electronic records during their clerkships.
3	Computer-based Testing	Adopt and implement computer-based testing capabilities.
3	Performance Tracking	Develop/adopt a unified, standard student performance tracking system that incorporates all forms of evaluation including classroom tests, faculty evaluations and procedural skills and competencies checklists.
4	Parity	Create parity in learning opportunities for medical students regardless of their personal financial ability to afford the equipment to take advantage of e-learning technologies.
4	eLearning Preparation	Prepare trainees for life-long e-learning by defining competencies in and teaching students e-learning methods.
4	eLearning Resources	Serve as an e-learning resource for teaching faculty (e.g. RPAP preceptors, residents, attendings), practicing physicians and health care systems in Minnesota.

Costs

The estimated costs of implementing these recommendations fall into two categories and do not take into account existing Medical School resources that might be available. Investments are one-time costs incurred for the purpose of the startup of the recommended action. Continuing costs are those necessary for maintaining the functions of the recommendations once they have been implemented. Both categories include personnel costs, but those in the investment category are restricted to a defined period of time not exceeding three years. The total investment costs for all recommendations per enrolled medical student (not counting residents) over a three year implementation period range from $496 to $2,676. In addition, the annual continuing costs range from $658 to $1,713 per medical student. The number of FTEs of various classes required to implement all recommendations is estimated to be from 8.15 to 11.5 for continuing operations. The investment costs incorporated a range of 5.5 to 9.0 FTE years of effort.

Introduction

Information technology is playing an increasing prominent role in higher education. Even when administrative uses such as on-line course registration are excluded, the uses of computer-based applications for teaching and learning are disseminating with considerable speed throughout our college and university systems. This approach, now becoming known as technology enhanced learning or TEL has become a priority initiative at the University of Minnesota. Administrative units have been created at the University Provost’s level and within the Academic Health Center. This prioritization is reflected in the interest and activities of the faculty, many of whom have embraced components of technology enhanced learning for their teaching responsibilities. In Fall 2004, 1,054 courses at the University of Minnesota have a WebCT website. Each of the schools in the Academic Health Center is making investments in a variety of TEL approaches from using interactive videoconferencing to creating a virtual classroom involving students in the Twin Cities and Duluth to using simulators to teach clinical skills.

At the same time students have come to realize and are now demanding information technology tools to assist them in their studies. Surveys of incoming medical students reveal that essentially 100% either have a computer or have ready access to one. By the time students enter their clinical years approximately 80% have purchased a personal digital assistant. Laptop computers are appearing in classrooms and students are increasingly dependent on the electronic resources made available by the Medical School and the Bio-Medical Library.

In July of 2000, the Medical School created the Education Informatics group in the Office of Medical Education on the Twin Cities campus to focus on TEL support for medical education in response to the 1999 LCME Report. This group has worked successfully with faculty and students to provide educational resources that primarily support undergraduate medical education. The Duluth campus has undertaken a similar initiative with equal if not greater success in deploying TEL applications for their students. In several respects the Duluth campus has assumed a leading role in classroom use of tablet PCs, in developing self instructional modules, and in web-based testing. In addition, several departments with specific course responsibilities have undertaking efforts to incorporate TEL into their courses and clerkships.

In October 2004 Dean Powell directed Senior Associate Dean Kathleen Watson and Director of Education Informatics Stuart Speedie to convene a task force for the purpose of considering the utility and costs of additional investments in technology enhanced learning for medical education and extending those investments to the graduate and continuing medical education. The motivation for this work arose out of the University of Minnesota’s planning priorities that placed additional emphasis on technology enhanced learning. It was also motivated by a desire to further explore ways by which vertical integration of medical education could be achieved, how these technologies could be employed to address the issues raised by the latest LCME report concerning the relationships between the Twin Cities and Duluth campuses and how TEL might play a role in addressing the larger issues facing medical education in the context of today’s health care system.

Charge to the Task Force

The Task force was charged with making recommendations regarding technology enhanced learning that would:

1. Ensure comparability of learning experiences for students across sites in the Medical School, with special emphasis upon the Duluth Campus, but also consideration of other sites, such as RPAP and the Twin Cities community sites for clinical medicine
2. Identify the equipment and technologic infrastructure required to facilitate vertical integration of teaching and off-schedule, self-directed learning for undergraduate and graduate medical education.
3. Identify the equipment and technologic infrastructure required to facilitate rigorous, reflective outcomes-based evaluation of student performance.
4. Review the medical educational literature and national (eg AAMC) task forces on the best practices in effective technology-enhanced learning and evaluation methods.
5. Provide examples of best practices in Technology-Enhanced Learning currently being used in UME, GME and CME at the University of Minnesota.
6. Create matrices of instructional and evaluation methods in technology-enhanced learning, as a reference for faculty.
7. Make recommendations for personnel needed to create and maintain new technologies.
8. Estimate the costs per student associated with the equipment, technologic infrastructure and personnel.

Membership List

The following representatives from the Medical School and the University of Minnesota agreed to serve on the Task Force:

Bryan Armitage	Student, Twin Cities Campus
Bradley Benson, MD	Faculty, Medicine (pediatrics)
Adam Boettcher	Student, Twin Cities Campus